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Play Reflect Connect

Collaborating to bring a new social-skills program to virtual life.

Patricia Angermeier, OTR/L, has been a pediatric therapist for over 25 years. Recently, she collaborated with Deborah Haggett, EdD, MSW, LCSW, play therapist and licensed clinical social worker, and Steve Hochman, a computer game designer, to create a new social-skills program, FACES (Fun Activities to Connect, Engage and Socially Succeed), that focuses on non-verbal communication skills through computer games and video self-modeling. The program was featured in the Oct. 8, 2012 print issue of ADVANCE, "Fostering Social Skills with Technology." Below, Angermeier shares more about the development of this program, the use of technology to achieve therapeutic goals, and the process of collaboration with other professionals. For more information and to play the games, visit or contact Angermeier at

ADVANCE: What lead you to create Play Reflect Connect?

Angermeier: For the last several years I have worked with special educators and speech-language pathologists on social skills programs. What I found is my students seemed to be missing important foundational skills for true interaction with others. Some were very verbal and capable of producing long, one-sided conversations but were unable to pick up cues when to stop or change a conversation. Others were unaware of the listener's feelings related to the verbal interaction or another speaker's intent. 

As I delved deeper uncovering the road blocks to accurate and perceptive reciprocal interactions, I discovered that some of the areas that were not addressed in a comprehensive, developmental sequence were in the domain of nonverbal communication skills. These skills included: physical proximity and orientation, eye gaze, joint visual attention and the ability to read and portray facial expressions. Searching the literature for programs and research, I found several authors that had some of these areas identified but not fully addressed in a lesson plan format for a classroom activity. 

In addition, in my work in a school setting, I often found other professionals also seeking to help students in the social domain. More typically, the demands of the school schedule along with the need for each professional to meet their specific goals of the IEP fostered an environment where professionals worked individually with students in a more isolated construct, rather than collaborating to meet student needs. 

Given my experience with social programs that seemed limited in the nonverbal area and my observation of isolated program implementation, I decided to reach out to other professionals to develop a more comprehensive approach to social-skills programming. As an occupational therapist in a clinical and educational setting, I collaborated with special educators, speech-language pathologists, counselors and psychologists.

I started by creating a very developmental sequence of skill acquisition from physical proximity to beginning perspective-taking skills. But the manner of instruction had to be concrete, repetitive, physically active, multisensory, highly visual, and have the added components of instructor and caregiver education as well to ensure the transfer of skills into multiple environments. Nothing I found on the market at that time seemed to meet all of these requirements. So, I put together lesson plans to address all of these aspects and tried it out in a classroom of special needs kindergarteners.

At that point, I worked with Dr. Deborah Haggett in writing up my experiences with the kindergarteners. Together we created the book, FACES: Fun Activities to Connect, Engage, and Socially Succeed. Once we wrote it up, Steve Hochman formatted it, added the pictures, and helped us self-publish.

ADVANCE: What, initially, were your goals?

Angermeier: The goals focused on developing social skills through self awareness. We wanted to help kids see themselves and learn about personal presence, body proximity and orientation, and reciprocal communication. It was during this clinic group that one of the boys explained to me that he only looks at my mouth when he talks with me. That was an "aha" moment for me. I realized that I needed to help kids expand their visual context to include the entire face when speaking with others. Incredibly, I found research that supported this concept, which propelled me into developing the FACES program.

ADVANCE: How did you connect with game designer Steve Hochman and get him involved in the project?

Angermeier: While in the process of doing these lesson plans and working weekly with my kindergarten group, I had a meeting with a young woman from my payroll vendor. As I enthusiastically explained my interests and projects in schools, she became very engaged and suggested I meet with her dad, who was producing curriculum-based games for kids with kids in economically challenged environments and gifted and talented programs. When he showed me the video and computer games he was creating and the children's involvement, motivation, attention and excitement while playing and creating these customizable games, I was certain they could be an effective addition to the social skills program - especially in regard to reading facial expressions.

ADVANCE: How did you and Dr. Deborah Haggett come to work together?

Angermeier: After working on this program, I got reacquainted with Dr. Deborah Haggett. Debbie also had an interest and a great level of experience with social-skills development and intense interest in fostering social competence in children. In addition to being on the same page with me, Debbie brought an important aspect to this project because she was a special educator, counselor, clinical family counselor as well as a college instructor for a master's in education program. 

After she retired, I approached her about offering social-skills groups to children with ASD in the clinic setting. We created a six-week program introducing some of the same concepts of nonverbal communication and expanded it to include concepts of raising awareness of self-presence, awareness of others and reciprocal conversations. In our first clinical group, we invited Steve to come and videotape the participants during our interactive activities. We reviewed those video clips with the kids to help raise their awareness about their body language, their proximity and orientation, and their personal presence while interacting with others. 

In addition to the video self-modeling, Steve decided to take the clips and create a computer game which he called, Who Could That Be? The kids introduced themselves, their likes, their dislikes, etc. in the clips and Steve created a game with a question-and-answer format in which kids needed to recall "who said that?" It was a big hit with the kids and the families. It was the beginning of us understanding the power of video in helping clients not only become more aware of how they present themselves in relation to others, but to shift their focus from the self to the other. 

ADVANCE: What was the game development process?

Angermeier: We wanted to keep the format simple and engaging. What's My Mood? brings one image to the screen plus 8 buttons (one for each potential expression). To avoid frustration, when a player guesses incorrectly that button vanishes. The player then has only 7 choices, etc. until they match the answer to the image.

What's My Mood? tracks student progress in identifying facial expressions by accuracy and speed, both cumulatively and by each facial expression. Within a couple of weeks, I witnessed and had the data to show measureable progress in all the students and was able to see which expressions were most challenging. 

After doing the game with the first kindergarten group, we refined the game multiple times (with other groups), eventually developing a generic version with typical children working as models for the game. While the generic version works nicely, we found that when the participants see their own photos and the photographs of their friends in it, they're more engaged.

We drove Steve to make the game open content. The current version available from selected catalogs on CD and downloadable from our Play Reflect Connect website comes with instructions to customize the game with your own images.

Wanting to build on the momentum, we quickly followed with the more challenging Memory Mood MashUp game. MashUp offers three levels: 1) a concentration-style memory game involving finding and matching the same face; 2) matching the face with the emotional label; and 3) matching two different people expressing the same mood.

ADVANCE: What did you and Debbie learn about the technological aspects of developing such a game?

Angermeier: We continue to be amazed how adaptable games can be. In addition to score tracking, customization, replaceable images and video, our game guy keeps coming up with ways to do whatever we dream up. In fact, several of our games are now available as apps on Android phones and the Kindle Fire. We all bought Fires and use them with our students who feel more comfortable with touch screens than with keyboards.

Steve often comes up with suggestions for what a game should have. After we see a game used in the field, we give him feedback from the kids or from our observations. It could be changes as simple as moving the buttons from the bottom of the screen to the side or as complicated as organizing the way the questions or content comes up. (For example, Steve made a game with images of household objects, animals, fruits and vegetables. We suggested he make them compete by categories rather than all randomly.)

ADVANCE: How have you used video self-modeling as part of your work?

Angermeier: Debbie invited Steve to work with her middle school students. They created several games and activities using video self modeling. Debbie worked on the areas of eye gaze, interviewing skills, bullying, social intent and self-presence with these students. She was able to engage these students with the video production and feedback innate in this model of intervention.

Steve edited the clips according to Debbie's goals and input. Then he assembled the clips to: 1) allow students to see themselves in their best light; 2) develop interviewing skills (working with the students to shift their attention from the self and to ask questions of each other. Though the interviewers did not appear in the game, it was their questions that led to the content); and 3) engage participants to learn about the interests of others. 

For most of the videos, Debbie prepared her students by practicing initially without a camera. She worked with them on interviewing skills and prompted them to expand their conversations with additional questions and summary statements. She then shot some footage on her smartphone for the kids to review their scenarios. This definitely engaged them and motivated them to enhance their video images and personal presence.

Then Steve came in with his tripod and HD digital video camera for the main shoot. Steve gave the children multiple takes, as well as presentation tips. (He has directed and edited videos for major corporations including: CitiCorp, Verizon, and DuPont. He insists kids, even special needs kids, are easier to work with than corporate executives!)

ADVANCE: Were there scripts for the positive interactions you filmed?

Angermeier: Debbie worked with her students to develop scenarios, but the kids came up with dialog which they typically changed in the moment. They used prompts, but not scripts. When it came to shoot time, Steve wanted them to be as natural as possible and not be squinting to read cue cards or remember lines. It took more takes, but it provided a more genuine product.

ADVANCE: What kind of editing process occurred?

Angermeier: Steve compared Debbie's outlines to what the students actually presented and edited to come as close to the goal as possible without changing the meaning or intent of the students.

We've also used raw footage to work on eye contact, engagement and to review valuable nuggets that didn't fit into the game. Sometimes the best dialog comes off message. For example, during a bullying scenario several boys broke away to reveal what they don't like about others such sarcasm and mocking of them. But the video pointed out that one of the complainers was constantly sarcastic to others. It provided a powerful "aha" moment.

ADVANCE: What's the next step?

Angermeier: We continue to collaborate on projects and ideas to help incorporate still images and video into social-skills programs that help motivate, interest, and excite students' participation. When we found that these games and activities were very motivating for our students, we wanted to find a way that we could make these high-tech tools available to more people.

Steve worked diligently on this project as we completed the manual. He was able to construct a game that allowed the instructor to do what was unthinkable before -- create a customizable game with their students' photos inserted in the computer games. With the use of the manual, the instructor could teach the children the pre-lessons that were required for them to learn to portray and interpret the facial expressions. After that, the instructor could take the pictures with a camera or even a telephone and insert them into the photo files included with the customizable game. With a few clicks the computer program was personalized with their student photos.

But it didn't stop there, Steve created companion programs which when downloaded on the same computer immediately insert the customized photos into these other games. For more information about the customization process, you can visit our website.

Patricia Angermeier, OTR/L, has worked with children with special needs for over 25 years in both school and clinic settings. Along with Deborah I. Hagget and Steve Hochman, she is co-creator of the FACES (Fun Activities to Connect, Engage and Socially Succeed) program series that includes an instructors manual with lesson plans as well as several customizable video games for social-skills development. For more information and an opportunity to play the games, please visit .


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